Cefditoren

Indications
 Oral
Community-acquired pneumonia
Adult: 400 mg bid for 14 days.
CrCl (ml/min)Dosage Recommendation
30-49 Maximum: 200 mg bid
<30Maximum: 200 mg once daily

Oral
Acute bacterial exacerbation of chronic bronchitis
Adult: 400 mg bid for 10 days.
CrCl (ml/min)Dosage Recommendation
30-49Maximum: 200 mg bid
<30Maximum: 200 mg once daily

Oral
Pharyngitis
Adult: 200 mg bid for 10 days.
CrCl (ml/min)Dosage Recommendation
30-49Maximum: 200 mg bid
<30Maximum: 200 mg once daily

Oral
Tonsillitis
Adult: 200 mg bid for 10 days.
CrCl (ml/min)Dosage Recommendation
30-49Maximum: 200 mg bid
<30Maximum: 200 mg once daily

Oral
Uncomplicated skin and skin structure infections
Adult: 200 mg bid for 10 days.
CrCl (ml/min)Dosage Recommendation
30-49Maximum: 200 mg bid
<30Maximum: 200 mg once daily
Contraindications
 Hypersensitivity to Cefditoren, other cephalosporins; or milk proteins. Carnitine deficiency.
Warnings / Precautions
 Pregnancy and lactation. Patients with penicillin allergy. Avoid prolonged use as pivalate-containing compounds may cause carnitine deficiency over time; greater risk of carnitine deficiency in patients with renal impairment or decreased muscle mass. May decrease prothrombin activity especially in patients with renal or hepatic impairment, poor nutritional status, prolonged antibiotic treatment or patients previously stabilised on anticoagulant therapy. Long term use may result in development of drug-resistant bacteria, or superinfection including Clostridium difficile-associated diarrhoea and pseudomembranous colitis.
Adverse Reactions
 Diarrhoea, nausea, headache, abdominal pain, vaginal moniliasis, dyspepsia, vomiting, haematuria, increased urine white blood cells, decreased haematocrit, increased glucose, interstitial pneumonia, acute eosinophilic pneumonia, acute renal failure, arthralgia, thrombocytopenia, erythema multiforme. Pseudomembranous colitis symptoms may occur during or after antibiotic treatment.
Potentially Fatal: Hypersensitivity, anaphylaxis, Stevens-Johnson syndrome, toxic epidermal necrolysis.
Overdose Reactions
 As with other beta-lactam antibiotics, symptoms include nausea, vomiting, epigastric distress, diarrhoea, and convulsions. May be removed by haemodialysis.
Drug Interactions
 Reduced oral bioavailability when coadministered with antacids or H2-receptor antagonists. Probenecid may increase plasma concentration and prolong half-life of Cefditoren. May enhance anticoagulant effect of vitamin K antagonists (e.g. warfarin).
See Below for More cefditoren pivoxil Drug Interactions
Lab Interactions
 May induce positive direct Comb's test; false positive of copper reduction test for glucose in the urine. False negative result may occur in ferricyanide test.
Mechanism of Actions
 Cefditoren is a third generation cephalosporin used for treatment of susceptible infections caused by gram-positive and gram-negative bacteria. It inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs).
Absorption: Bioavailability is increased by about 14-16% when administered after a high fat meal.
Distribution: Mean Vd: About 9.3±1.6 L. Plasma protein binding: About 88% (in vitro); mainly to albumin.
Metabolism: Not significantly metabolised. Hydrolysed to Cefditoren (active component) and pivalate.
Excretion: Mean terminal elimination half life: About 1.6±0.4 hr. Excreted primarily into urine (as Cefditoren and pivaloylcarnitine); renal clearance reduced in patients with renal impairment.
Storage Conditions
 Oral: Store at 25°C (77°F); excursion permitted to 15-30°C. Protect from light and moisture.
Storage
 Oral: Store at 25°C (77°F); excursion permitted to 15-30°C. Protect from light and moisture.
Available As
  • Cefditoren 200 mg

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